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1.
目的应用决策树模型(CART),纳入总淋巴细胞(TLC)计数、血红蛋白(HGB)等多个血常规指标,研究未抗病毒治疗HIV感染者TLC与CD4~+T淋巴细胞(简称CD4细胞)计数的相关性,并与受试者工作特征曲线(简称ROC曲线)常规分类方法比较。方法选取昆山市未抗病毒治疗HIV感染者297例,采集433份血样标本,检测血常规指标和CD4细胞计数。将血常规指标与CD4细胞计数进行相关性分析,以CD4细胞计数≤350个/uL、≤500个/uL为临界点,分别计算CART、常规ROC曲线分类方法的灵敏度、特异度、阳性预测值(PPV)、阴性预测值(NPV)和约登指数。结果 TLC、HGB、白细胞(WBC)计数、红细胞(RBC)计数、血小板(PLT)计数、中性粒细胞(WLCC)计数与CD4细胞计数均显著相关(P0.05),纳入TLC、HGB、RBC、WBC指标,CART模型分类CD4细胞计数≤350个/uL的灵敏度、特异度、PPV、NPV和约登指数分别为36.4%、95.3%、84.2%、68.6%和0.317;纳入TLC、HGB、RBC指标,CART模型分类CD4细胞计数≤500个/uL的灵敏度、特异度、PPV、NPV和约登指数分别为92.0%、40.9%、78.0%、69.2%和0.329;两个CART模型均略优于ROC曲线分类方法。结论应用CART模型纳入TLC、HGB等多个血常规指标能有效预测CD4细胞计数,可在资源有限地区用于未治疗HIV感染者疾病进展监测。  相似文献   

2.
目的通过对AIDS合并结核病例的回顾性分析,探讨AIDS合并结核病临床特征与CD4 T淋巴细胞计数的相关性。方法对95例AIDS并发结核感染的病例CD4 T淋巴细胞计数进行检测,同时选择30例近期入院的HIV阴性肺结核病人CD4 T淋巴细胞计数的检测,AIDS合并结核病与HIV阴性肺结核病CD4 T淋巴细胞水平对比分析;AIDS合并结核中PPD、结明试验、结核分型与CD4 T不同水平进行相关性分析。结果AIDS合并结核病与HIV阴性结核病CD4 T淋巴细胞水平相比,二者有显著性差异;CD4 T淋巴细胞计数与艾滋病合并结核病的影象学表现;PPD、结明试验、痰涂片抗酸染色阳性率、结核病分型有相关性,CD4<100/mm3与CD4>100/mm3相比,影象学中斑片实变影、多发空洞、多发结节、纵隔和(或)腋下淋巴结肿大有显著性差异;单发空洞,胸腔积液的机率,无显著性差异。CD4<100/mm3与CD4>100/mm3相比,PPD、结明试验、痰涂片抗酸染色阳性率相比均有显著性差异;Ⅱ、Ⅴ型结核发生率有明显差异。结论AIDS患者合并结核病发病率高,尤其以肺外结核和血型播散性结核多见,CD4 T淋巴细胞计数低于100/mm...  相似文献   

3.
目的 对淋巴细胞计数预测CD4+ T细胞计数的准确性进行评价,为临床应用提供支持.方法 在全国23个分中心共筛查2 013例未接受抗病毒治疗的HIV/AIDS患者,经流式细胞术检测CD4+ T细胞计数,分析血常规当中的淋巴细胞计数和CD4+ T细胞计数之间的相关性,绘制ROC曲线判断淋巴细胞计数预测CD4+T细胞计数的准确性,并计算其敏感度、特异度、阳性预测值和阴性预测值.结果 2 013例HIV/AIDS患者的淋巴细胞计数和CD4+ T细胞计数分别为(1 600±670)×106/L和(244±148)×106/L,两者呈现显著正相关性(r=0.482,P<0.000 1),以淋巴细胞计数预测CD4T细胞计数<100×106/L、<200×106/L和<350×106/L的AUCROC分别为0.790(95% CI0.761 ~0.818,P<0.000 1),0.733(95% CI0.710 ~0.755,P <0.000 1)和0.732 (95% CI0.706 ~0.758,P <0.000 1).结论 在HIV/AIDS患者的临床诊治中,用淋巴细胞计数预测CD4+ T细胞计数有其实用价值,可以考虑在不具备CD4+ T细胞计数直接检测时作为替代指标用于监测疾病进展,也可以在获得CD4+ T细胞计数结果之前用来初步快速判断患者病情.  相似文献   

4.
目的 探讨人类免疫缺陷病毒(HIV)感染者和获得性免疫缺陷综合征(AIDS,艾滋病)患者(HIV/AIDS)外周血总淋巴细胞数(TLC)和CD4+ T细胞计数的相关性,明确将TLC作为HIV/AIDS疾病进展监测指标的可行性.方法 分析2000年1月至2006年5月在北京协和医院艾滋病诊疗中心诊治的未经抗病毒治疗的317例HIV/AIDS患者TLC和CD4+ T细胞计数之间的相关性,判断TLC代替CD4+ T计数<100×106/L,<200×106/L和<350×106/L的准确度和最佳临界值,计算各临界值的敏感度、特异度、阳性预测值和阴性预测值.结果 317例HIV/AIDS患者外周血TLC和CD4+T细胞计数[中位数(25%分位数,75%分位数),单位为×106/L]分别为1300(1754,932)和242(384,86),二者呈显著正相关性(r=0.722,P<0.01).以TLC预测CD4+ T细胞计数<100×106/L,<200×106/L和<350×106/L具有较高准确度,其ROC曲线下面积分别达到0.866、0.853和0.863(P均<0.01).随着TLC临界值取值的降低,敏感度逐渐减低,特异度则逐渐增大.结论 该研究结果为应用TLC作为监测HIV/AIDS初诊、初治患者疾病进展和确定抗病毒治疗时机的替代指标提供了试验依据.  相似文献   

5.
目的探讨人类免疫缺陷病毒(HIV)感染者和获得性免疫缺陷综合征(AIDS,艾滋病)患者(HIV/AIDS)外周血总淋巴细胞数(TLC)和CD4 T细胞计数的相关性,明确将TLC作为HIV/AIDS疾病进展监测指标的可行性。方法分析2000年1月至2006年5月在北京协和医院艾滋病诊疗中心诊治的未经抗病毒治疗的317例HIV/AIDS患者TLC和CD4 T细胞计数之间的相关性,判断TLC代替CD4 T计数<100×106/L,<200×106/L和<350×106/L的准确度和最佳临界值,计算各临界值的敏感度、特异度、阳性预测值和阴性预测值。结果317例HIV/AIDS患者外周血TLC和CD4 T细胞计数[中位数(25%分位数,75%分位数),单位为×106/L]分别为1300(1754,932)和242(384,86),二者呈显著正相关性(r=0.722,P<0.01)。以TLC预测CD4 T细胞计数<100×106/L,<200×106/L和<350×106/L具有较高准确度,其ROC曲线下面积分别达到0.866、0.853和0.863(P均<0.01)。随着TLC临界值取值的降低,敏感度逐渐减低,特异度则逐渐增大。结论该研究结果为应用TLC作为监测HIV/AIDS初诊、初治患者疾病进展和确定抗病毒治疗时机的替代指标提供了试验依据。  相似文献   

6.
目的了解中国湖北成人CD4抗原阳性的T淋巴细胞(CD4)、CD8抗原阳性的T淋巴细胞(CD8)、CD3抗原阳性的T淋巴细胞(CD3)及CD4/CD8、CD4/CD3正常值参考范围,以及总淋巴细胞计数(TLC)与CD4之间的关系.方法选取120例15~60岁健康人不同年龄组的血标本,用Becton Dickinson公司生产的FACSCount自动化仪检测CD4、CD8、CD3、CD4/CD8、CD4/CD3,计算相关数据的正常值参考范围,并将其与国外数据作比较.用美国雅培CEILDYN(R)3700血液全自动分析仪作全血总淋巴细胞计数.结果CD4值为681±21/mm3(-x±Sd,以下相同),CD8值为510±26/mm3,CD3值为1 299±38/mm3,CD4/CD8值为1.43±0.06,CD4/CD3值为0.54±0.10,TLC值为1 752±48/mm3.CD4、CD8、CD3计数及CD4/CD8、CD4/CD3在不同性别、年龄组之间差别无显著性.CD4与TLC之间有显著的直线正相关性,r=0.647,回归方程为√CD4=0.422√TLC+8.444.结论CD4、CD3、CD8等正常值在不同性别、年龄间相近.中国湖北成人CD4值与中国上海成人之间无差别,但显著低于国外值.在无条件检测CD4计数的情况下,可用TLC推测CD4的值.中国现有的治疗标准需要进一步探讨.  相似文献   

7.
赵磊  王念跃  张红梅 《山东医药》2011,51(36):97-99
目的探讨用血常规多项指标检测联合预测HIV感染者CD4 T淋巴细胞计数的可行性。方法分别对61例HIV感染者全血样本进行外周血淋巴细胞计数、白细胞计数、单核细胞计数与淋巴细胞绝对计数检测。结果 HIV感染者外周血白细胞计数、淋巴细胞计数、单核细胞计数与淋巴细胞亚群:CD3、CD4、CD8计数均具有显著相关性;外周血白细胞计数、单核细胞计数与淋巴细胞亚群:CD3CD4CD8、CD4/CD3不具有显著相关性;外周血淋巴细胞计数与淋巴细胞亚群CD3CD4CD8计数具有显著相关性;外周血淋巴细胞计数与淋巴细胞亚群CD4/CD3不具有显著相关性。结论通过外周血白细胞计数、淋巴细胞计数、单核细胞计数检测进行HIV感染者CD3、CD4、CD8计数预测具有一定可行性,通过外周血淋巴细胞计数检测进行HIV感染者CD3CD4CD8计数预测具有一定可行性。  相似文献   

8.
AIDS患者贫血与CD4+细胞计数的关系   总被引:5,自引:1,他引:4  
金铭  张可 《传染病信息》2004,17(4):161-163
目的观察HIV/AIDS患者贫血与CD4 细胞计数的关系.方法对192例HIV/AIDS患者的CD4 细胞计数、血红蛋白、贫血的发生率进行统计学分析.结果①不同CD4 细胞计数分组的血红蛋白(HGB)差异有显著性意义(P=0.000),CD4 <100/mm3的HGB与CD4 >100/mm3各组的HGB的差异均有显著性意义,而CD4 >100/mm3各组间的HGB的差异无显著性意义;②CD4 <200/mm3时贫血的发生率(12.9%)高于CD4 >200/mm3贫血的发生率(2.5%),两者的差异有显著性意义(P=0.01);③贫血与否与CD4 细胞计数的差异有显著性意义(P=0.024),贫血(HGB<10g/dl)者CD4 细胞计数的范围是148±166/mm3.结论HIV/AIDS患者CD4 <200/mm3时贫血的发生率增加.  相似文献   

9.
目的观察中医药治疗艾滋病试点项目中,连续接受中药治疗36个月的807例艾滋病病毒(HIV)/艾滋病(AIDS)病人CD4淋巴细胞计数的变化情况,以探讨长期中药治疗对病人免疫功能的影响。方法用自身前后对照的方法 ,对807例HIV/AIDS病人经中医药治疗后7个时点(疗前、6、12、18、24、30、36个月)的CD4计数变化、分层分析(200个/mm3、200~350个/mm3、350个/mm3)、不同病期、不同干预手段、可能感染时间等方面进行分析,并对7个时点主要症状积分的变化进行观察。结果中药对CD4计数200个/mm3和200~350个/mm3之间的病人效果较好;可能感染时间集中在1990-1995年之间的病人,服用中药3年CD4的水平基本保持稳定;中西药合用的效果优于单纯使用中药。结论长期服用中药可以稳定病人的免疫功能,远期疗效较好。  相似文献   

10.
目的观察中医药治疗艾滋病试点项目中,连续接受中药治疗36个月的807例艾滋病病毒(HIV)/艾滋病(AIDS)病人CD4淋巴细胞计数的变化情况,以探讨长期中药治疗对病人免疫功能的影响。方法用自身前后对照的方法 ,对807例HIV/AIDS病人经中医药治疗后7个时点(疗前、6、12、18、24、30、36个月)的CD4计数变化、分层分析(〈200个/mm3、200~350个/mm3、〉350个/mm3)、不同病期、不同干预手段、可能感染时间等方面进行分析,并对7个时点主要症状积分的变化进行观察。结果中药对CD4计数〈200个/mm3和200~350个/mm3之间的病人效果较好;可能感染时间集中在1990-1995年之间的病人,服用中药3年CD4的水平基本保持稳定;中西药合用的效果优于单纯使用中药。结论长期服用中药可以稳定病人的免疫功能,远期疗效较好。  相似文献   

11.
涂波  秦恩强  黄磊  王利  赵敏 《传染病信息》2011,24(6):342-343,350
目的 分析HIV感染者外周血淋巴细胞总数(total lymphocyte count,TLC)与CD4+T淋巴细胞计数相关性,探讨将外周TLC作为监测HIV感染者病情变化指标的可行性.方法 回顾性分析我院54例HIV感染者TLC与CD4+T淋巴细胞计数相关性,判断CD4+T淋巴细胞计数分别<100× 106/L、<2...  相似文献   

12.
This study evaluated total lymphocyte count (TLC) as a substitute marker for CD4+ cell counts to identify patients who need prophylaxis against opportunistic infection (CD4 < 200 cells/mm(3)) and patients with CD4 < 350 cells/mm(3) (Brazilian threshold value of CD4 count to define AIDS). We evaluated TLC and CD4+ cells count of 1,174 HIV-infected patients, in Salvador, Brazil, from May 2003 to September 2004. CD4+ cell counts were performed by flow cytometry, and TLC was measured with an automated hematological counter. The mean CD4 count was 430 cells/mm(3) (range: 4 to 2,531 cells/mm(3)). Mean TLC was 1,900 cells/mm(3) (range: 300 to 6,200 cells/mm(3)). Using a threshold value of 1,000 cells/mm(3) for TLC, the positive predictive value (PPV) was 77% for CD4 < 200 cells/mm(3), but the sensitivity was only 29%, while the negative predictive value (NPV) was 88%, with 98% specificity. Similar findings were observed for CD4 count < 350. Using the same threshold value of 1,000 cells/mm(3) for TLC, sensitivity was 14%, and specificity 99% (PPV= 94%; NPV=62%). In 70/1,510 (5%) of the samples the sum of CD4 and CD8 cell counts was greater than the TLC and in 27% (419/1,510) this sum was below 65% of the TLC. TLC has a high specificity to identify patients for prophylaxis, but a quite low sensitivity. It is not useful as an alternative to CD4+ T-cell counts as a marker in HIV-infected patients.  相似文献   

13.
目的根据艾滋病病毒(Human immunodeficiency virus,HIV)感染者的总淋巴细胞计数(Total lyopho-cyte count,TLC)预测CD4+T淋巴细胞计数<200个/μL的值进行系统评价。方法检索中英文文献,并根据纳入标准对文献进行筛选。利用Meta-DiSc 1.4和Stata/SE 12.0软件,对纳入的研究结果按不同的TLC临界值分别进行合并灵敏度、特异度、阳性预测值、阴性预测值的计算,绘制不同临界值的综合受试者工作特征曲线,计算曲线下面积并进行比较。结果共筛选文献12篇,按TLC临界值分别为1 200个/μL、1 300个/μL、1 400个/μL及1500个/μL进行Meta分析。以TLC<1 200个/μL预测CD4<200个/μL的合并灵敏度和特异度分别为0.62[95%可信区间(Confidence interval,CI):0.60~0.64]和0.81(95%CI:0.80~0.82)。不同TLC临界值下的综合受试者工作特征曲线下面积不相同,但差异无统计学意义。结论以TLC<1 200个/μL预测CD4<200个/μL时准确性最高,此结果与世界卫生组织的建议一致。  相似文献   

14.
OBJECTIVE: To develop clinical algorithms that improve the sensitivity of surrogate markers to initiate the use of highly active antiretroviral therapy (HAART) in resource-limited settings. DESIGN: A retrospective evaluation of total lymphocyte counts (TLC) and hemoglobin to predict the CD4 lymphocyte count. METHODS: A total of 3269 members of the Johns Hopkins HIV observational cohort contributed 22 690 paired observations of CD4 lymphocyte counts and TLC. Two methods were used to evaluate the effect of combining TLC and hemoglobin to predict CD4 cell counts below 200 cells/mm3 before the initiation of HAART in 1451 participants; 55.3% of participants had CD4 cell counts below 200 cells/mm3. RESULTS: TLC below 1200 cells/mm3 and hemoglobin below 12 g/dl significantly predicted CD4 cell counts below 200 cells/mm3. For TLC alone sensitivity was 70.7% and specificity was 81.7%. For both men and women, we chose a TLC lower cutoff point of 1200 cells/mm3, an upper cutoff point of 2000 cells/mm3, and hemoglobin of 12 g/dl. For men, method I generated sensitivity of 78.0% and specificity of 77.5%. Method II improved specificity to 81.8%. For women, method I increased sensitivity to 85.6% and decreased specificity to 64.1%. Method II improved specificity to 81.4%. CONCLUSION: TLC below 1200 cells/mm3 were associated with CD4 cell counts below 200 cells/mm3 as in the WHO guidelines, but sensitivity was low. Adding hemoglobin to TLC increased sensitivity, thereby reducing the risk of false-negative results. Our model may serve as a template for the development of algorithms to initiate the use of HAART in resource-limited settings.  相似文献   

15.

Objective

To determine the use of total lymphocyte count as a surrogate marker for CD4+ cell count among HIV infected patients at the University of Gondar Hospital.

Methods

A retrospective cross sectional study was conducted at the University of Gondar Hospital antiretroviral therapy laboratory from December 2011 to May 2012. Data on CD4+ cell count, total lymphocyte count, sex, and age were collected from 2964 HIV infected patients and analyzed using SPSS version 16 computer software.

Results

Total lymphocyte count was significantly correlated with CD4+ cell count (P<0.001; r2=0.434). The sensitivity, specificity, positive predictive value, negative predictive value of total lymphocyte count<1 200 cells/mm3 to predict CD4+ cell count <200 cells/mm3 was 57.8%, 86.4%%, 34.1%, 86.39%, respectively. A total lymphocyte count<1 000cells/mm3 was found to have suboptimal sensitivity (69.0%), and specificity (85.0%) for predicting a CD4+ cell count <200 cells/mm3.

Conclusions

Total lymphocyte count and CD4+ cell count was positively correlated. Hence, lymphocyte count less than or equal to 1 000/mm3 can be used as a cutoff value in place where there is no CD4+ cell counting machine.  相似文献   

16.
Objectives Total lymphocyte counts (TLC) may be used as an alternative for CD4 cell counts to monitor HIV infection in resource‐limited settings, where CD4 cell counts are too expensive or not available. Methods We used prospectively collected patient data from an urban HIV clinic in Indonesia. Predictors of mortality were identified via Cox regression, and the relation between TLC and CD4 cell counts was calculated by linear regression. Receiver operating characteristics (ROC) curves were used to choose the cut‐off values of TLC corresponding with CD4 cell counts <200 and ≤350 cells/μl. Based on these analyses, we designed TLC‐based treatment algorithms. Results Of 889 antiretroviral treatment (ART)‐naïve subjects included, 66% had CD4 cell counts <200 and 81% had 350 ≤ cells/μl at baseline. TLC and CD4 cell count were equally strong predictors of mortality in our population, where ART was started based on CD4 cell count criteria. The correlation coefficient (R) between TLC and √CD4 was 0.70. Optimal cut‐off values for TLC to identify patients with CD4 cell counts <200 and ≤350 cells/μl were 1500 and 1700 cells/μl, respectively. Treatment algorithms based on a combination of TLC, gender, oral thrush, anaemia and body mass index performed better in terms of predictive value than WHO staging or TLC alone. In our cohort, such an algorithm would on average have saved $14.05 per patient. Conclusion Total lymphocyte counts is a good marker for HIV‐associated mortality. Simple algorithms including TLC can prioritize patients for HIV treatment in a resource‐limited setting, until affordable CD4 cell counts will be universally available.  相似文献   

17.
Understanding the total lymphocyte count (TLC)-CD4 count relationship could aide design predictive instruments for making clinical decisions during antiretroviral therapy, especially in underserved resource-poor settings. We performed multiple regression analyses to assess the prediction of CD4 count using TLC on 771 participants with 4,836 visits. In linear and logistic regression TLC, hemoglobin, gender, history of AIDS, and weight predicted CD4 count and CD4 < 200, respectively, before and after highly active antiretroviral therapy (HAART) use. On HAART, the adjusted odds ratios (OR) for TLC < 1500 (optimal TLC cutoff) were 5.1 (95%CI 4.0, 6.5; P < 0.001), and off HAART, 4.6 (95%CI 3.4, 6.2: P < 0.001) with high predictive power. TLC predicts CD4 count and CD4 < 200 cells/microL well during HAART. Including the additional factors improves performance. TLC is simple and inexpensive and can be used in many ways to develop clinical decision-making tools in underserved resource-poor settings during HAART therapy.  相似文献   

18.
Clinical criteria are recommended to select HIV-infected patients for initiation of antiretroviral therapy when CD4 lymphocyte testing is unavailable. We evaluated the performance characteristics of WHO staging criteria, anthropometrics, and simple laboratory measurements for predicting CD4 lymphocyte count (CD4 count) <200 cells/mm(3) among HIV-infected patients in Tanzania. A total of 202 adults, diagnosed with HIV infection through community-based testing, underwent a detailed evaluation including staging history and examination, anthropometry, complete blood count, erythrocyte sedimentation rate (ESR), and CD4 count. Univariable analysis and recursive partitioning were used to identify characteristics associated with CD4 count 200 cells/mm(3). Of 202 participants 109 (54%) had a CD4 count <200 cells/mm(3). Characteristics most strongly associated with CD4 count <200 cells/mm(3) (p-value <0.0001) were the presence of mucocutaneous manifestations (72% vs. 28%), lower total lymphocyte count (TLC) (median 1,450 vs. 2,200 cells/mm(3)), lower total white blood cell count (median 4,200 vs. 5,500 cells/mm(3)), and higher ESR (median 95 vs. 53 mm/h). In a partition tree model, TLC <1,200 cells/mm(3), ESR >or=120 mm/h, or the presence of mucocutaneous manifestations yielded a sensitivity of 0.85 and specificity of 0.63 for predicting CD4 count <200 cells/mm(3). The sensitivity of the 2006 WHO Staging system improved from 0.75 to 0.93 with inclusion of these parameters, at the expense of specificity (0.36 to 0.26). The presence of mucocutaneous manifestations, TLC <1,200 cells/mm(3), or ESR >or=120 mm/h was a strong predictor of CD4 count <200 cells/mm(3) and enhanced the sensitivity of the 2006 WHO staging criteria for identifying patients likely to benefit from antiretrovirals.  相似文献   

19.
CD+8 T细胞激活分子CD38、HLA-DR与HIV-1载量的相关性研究   总被引:2,自引:0,他引:2  
Han Y  Qiu ZF  Li TS  Xie J  Zuo LY  Kuang JQ  Wang AX 《中华内科杂志》2006,45(6):459-462
目的研究HIV/AIDS患者CD8^+ T细胞表达激活分子CD38、HLA-DR水平与血浆病毒载量(VL)的相关性,以及用CD8CD38、CD8HLA-DR比例替代VL检测的可行性.方法用流式细胞术分析103例接受12个月高效抗逆转录病毒治疗(HAART)患者的CD+8 T细胞表达CD38和HLA-DR水平;用分支DNA扩增技术检测血浆VL.用敏感性、特异性、准确性等参数分析能有效预测VL<50拷贝/ml、VL<500拷贝/ml、VL>1000拷贝/ml和VL>10 000拷贝/ml时CD8CD38和CD8HLA-DR的检测范围.结果103例艾滋病患者CD38、HLA-DR和VL在12个月治疗中均呈下降趋势;CD38和VL在HAART治疗前及治疗第1、3、6、9、12个月6个检测点的总相关系数为0.483(P<0.001)、HLA-DR和VL的总相关系数为0.477(P<0.001).用CD8CD38和CD8HLA-DR的水平预测VL值有显著诊断价值:当CD38<68.5%和<72.5%时预测VL<50拷贝/ml和<500拷贝/ml有较高的灵敏度和特异性;当HLA-DR在>39.5%和>46.5%时预测VL>1000拷贝/ml和>10 000拷贝/ml有较高的灵敏度和特异性.结论在条件匮乏的艾滋病高发区,可以用CD8CD38和CD8HLA-DR激活亚群的结果来预测血浆VL,作为监测HIV疾病进展和评价抗病毒疗效的参考.  相似文献   

20.

Objectives

To describe the prevalence and risk factors of poor CD4 count rise despite a good virological response on highly active antiretroviral treatment (HAART).

Methods

The patients from the EuroSIDA study who started HAART with a baseline CD4 count of <350 cells/μL and where all viral load (pVL) measures remained below 500 HIV‐1 RNA copies/mL between 6 and 12 months after the start of HAART were included. The risk factors for poor CD4 count rise were analyzed by multiple regression.

Results

Seven hundred and eighty patients were included. A low CD4 count response was observed in 225 patients (29%). The risk factors for this condition were older age, lower CD4 count at baseline, higher increase from the nadir to baseline CD4 count and lower pVL at baseline. Patients taking ≥one drug from each of the three antiviral classes were more likely to have a good CD4 response but a minority of the study participants was taking this treatment regimen (3.1%) and the confidence interval was large.

Conclusions

A poor immune reconstitution despite a good virological control is frequent after initiation of HAART among patients with a baseline CD4 count of <350 cells/μL. The underlying mechanisms leading to this condition seems mainly driven by the age and the baseline immunological and virological status of the patients.
  相似文献   

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